Require reimbursement of recovery support services
Recommendation
Congress should pass legislation to require reimbursement of recovery support services (RSS) and require the Department of Health and Human Services (HHS) to implement guidelines and reimbursement policies for RSS, which include peer-to-peer programs, jobs and life skills training, supportive housing, and recovery housing.[1]
Background/summary
Recovery support services (RSS) are non-clinical services utilized by individuals recovering from a mental health or substance use disorder (MH/SUD).[1][2] These services provide system-level support to reduce barriers to education, employment, and housing and connect individuals and their families with additional support in the community.[2] There are several challenges in providing RSS to individuals with MH/SUD, including cost and lack of collaboration between support programs.[3] The Recovery-Oriented Systems of Care (ROSC) framework highlights the importance of RSS and describes how these services should be implemented before, during, and after MH/SUD treatment.[4] The Department of Health and Human Services (HHS) should implement guidelines for RSS using this framework as a model.[1]
Additionally, Congress should act to improve reimbursement of RSS.[1] For example, the Maximizing Opioid Recovery Emergency (MORE) Savings Act, as introduced in the 118th Congress, would require the Center for Medicare and Medicaid Innovation (CMMI) to test a model providing RSS under Medicare without cost-sharing, allow Medicaid to cover RSS as part of medication-assisted treatment (MAT), and require private health insurance coverage of MAT-associated RSS at no cost.[5][6]
citations
1. Presidential Commission. The President’s Commission On Combating Drug Addiction and the Opioid Crisis. Last Updated 2017.
2. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. Recovery and Recovery Support. Last Updated April 24, 2023.
3. U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Human Services Policy. Challenges in Identifying and Supporting Human Services Participants with Substance Use Disorder. Last Updated May 25, 2022.
4. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. Recovery-Oriented Systems of Care Resource Guide. Last Updated September 2010.
5. Maximizing Opioid Recovery Emergency (MORE) Savings Act. H.R.1620 (Dean-McGarvey) and S.818 (Casey-Blumenthal), 118th Congress (2023-2024). Last Updated March, 2023.
6. Madeleine Dean, U.S. House of Representatives, Pennsylvania; Bob Casey, U.S. Senate, Pennsylvania. Dean and Casey Introduce Bill to Lower Costs of Treatment for Opioid Use Disorder (Press Release). Last Updated March 15, 2023.